Health

Dr. Victor Strasburger Interview Extras

By Whitny Doyle

Jeff Vespa

Dr. Victor Strasburger

On adolescent reproductive health:

“The United States is hysterical about teen sex. We’re the only Western country that still thinks that giving kids access to birth control means they’re going to start having sex, despite numerous studies showing that that’s not true and despite the fact that every other Western country has gotten over this. Giving teenagers access to birth control does one thing and one thing only: It increases their use of birth control. It doesn’t make them sexually active at a younger age, doesn’t increase the number of partners, it doesn’t increase the frequency that they have sex. And we’re still wrestling with this issue. It was an issue when I was growing up. And it’s time for it to end.”

On changing attitudes about teen sex:

“I think people have to be convinced that it’s not a moral issue, it’s not an ethical issue. It’s an economic issue. Your property taxes go up when teenagers are having babies. If you’re anti-abortion, you should be pro-contraception. So there are good economic reasons, and good moral and ethical reasons for that matter. If you’re anti-abortion, let’s prevent teen pregnancy to begin with. N.M. has one of the highest teen pregnancy rates in the country.

This is a big issue for New Mexico because a lot of money goes into helping teens who are pregnant and delivering babies. They tend to do less well in school, they drop out of school, they are poorer in terms of socioeconomic status. Society suffers when teenagers get pregnant. So it is a huge issue for this country. It is a mystery to me why we can’t understand that giving kids access to birth control protects them. Our job as adults is to get kids through adolescence as unscathed as possible.”

On teens and the media:

“Everything in society says sex sex sex. Kids see 15,000 sexual references a year on TV alone, and the media are not ‘abstinence only.’ The media are now the leading sex educator in the country.

I think parents and teachers need to understand is the media are a very powerful teacher of children and teenagers. And kids now spend more than seven hours a day with a variety of different media. That’s more time than they spend at school. So the media are teaching them about sex, about drugs, about relationships, about eating, about aggression and violence, there’s almost nothing that the media do not have an impact on when we think about child and adolescent health.

If you ask me what’s the single most dangerous aspect of media, it’s teaching the notion of justifiable violence. But there are many others. If you’re spending seven hours a day with media, you’re not out exercising, you’re not playing on a sports team. If you have a TV or internet connection in your bedroom, you’re at least twice as likely to be obese. So there are all kinds of repercussions about media that parents and teachers don’t understand.

If I see a kid who is watching a lot of sexual content on TV, I’m worried about whether or not they are sexually active and whether or not they are contracepting, because there’s very little talk in the mainstream media and movies about using birth control. If they’re watching a lot of music videos I’m worried about them drinking and smoking. If they’re playing a lot of first person shooter video games, I’m worried about their aggressive impulses. There are a lot of ways that just sitting and talking to teenagers can get you a good idea of what risky behaviors they might be engaging in, and what you need to talk to them about.”

On using the media to talk to teens about health issues:

“For parents of teenagers, instead of the ‘Big Talk,’ use media to talk to your teenager. You’re sitting there watching something and a sexy commercial comes on, or there’s some wisecrack about prostitutes or condoms or whatever, use that to turn to your teenager and say, ‘What do you think of that?’ Instead of trying to get your teen under a single light bulb in the middle of a darkened room with a chair in the middle saying, ‘Have you ever had sex, are your friends having sex, do you use drugs?’ It’s much easier to point to the TV screen and say, ‘What do you think of that? Why is she having sex with him? Why is it funny when somebody gets drunk? What happens if he gets into a car and tries to drive home?’ Much easier discussion than having a ‘Big Talk.’

On teens as patients:

“Teens are really unique. Sometimes they are like big children, sometimes they are like small adults, and sometimes they are uniquely adolescent. When they come in with a particular sign or symptom, unless you know what category they fit in to, you’re going to get yourself into a heap of trouble.

Teenagers are exquisitely sensitive human beings. They don’t act like it. But they are, particularly when they themselves are involved. They can be sensitive to others too. They don’t like coming into big general hospitals, they don’t like being seated in waiting rooms with either crying babies or old folks, they really need their own space and it’s difficult in a big medical center to convince people that that should be a priority because there’s no money in it.

The ideal adolescent clinic would be kind of a private practice setting. A house that was converted into doctors’ offices, where teenagers could come and go, parking was easy, and they could have their own medical staff who were there because they liked seeing teenagers and they were knowledgeable about them. That’s the ideal. Within the state, there need to be places where teens are comfortable being seen, being able to walk in, not being hassled about parental consent, those sorts of issues. And we’re far from that kind of ideal situation.”